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迈向消除人类非洲锥虫病

[Towards elimination of human African trypanosomiasis].

作者信息

Solano Philippe, Courtin Fabrice, Kaba Dramane, Kagbadouno Moïse, Rayaisse Jean-Baptiste, Jamonneau Vincent, Bucheton Bruno, Bart Jean-Mathieu, Thevenon Sophie, Lejon Veerle

机构信息

Université Montpellier, Institut de recherche pour le développement (IRD), Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), UMR Intertryp Montpellier, France.

Représentation IRD Ouagadougou, Burkina Faso.

出版信息

Med Trop Sante Int. 2023 Feb 10;3(1). doi: 10.48327/mtsi.v3i1.2023.317. eCollection 2023 Mar 31.

Abstract

Human African Trypanosomiasis (HAT) is caused by which is transmitted by the tsetse fly insect vector ( spp). It is one of the 20 Neglected Tropical Diseases (NTD) listed by the WHO. These diseases affect the poorest and most vulnerable communities, for which the WHO has established a dedicated 2021-2030 roadmap. At the time of Alphonse Laveran, HAT devastated the African continent. In the 1960s, the disease was nearly under control, but it strongly re-emerged in the 1990s. A coordinated effort of all stakeholders, with national control programs as the main actors, a strong contribution of research and important donations by the private sector, allowed to decrease the HAT burden significantly. Since 2018, less than 1000 cases are detected annually. We here review new diagnostics, treatments and vector control tools that have been implemented jointly and successfully in several endemic countries.The next key challenge will be to sustain the gains. Newly emerging research questions include long-term carriage of trypanosomes and adaptation of tools to low prevalence contexts. Challenges out of the research area comprise the continued need of funding, maintenance of dedicated human resources, and the key question of access. Sustainable elimination as "interruption of transmission", which is the 2030 NTD roadmap target, can be reached, if these challenges are solved. We stress the importance of continuing to combine the efforts in the fight against the disease, because sustainable elimination of HAT is the best long-term prevention strategy against re-emergence. As such, HAT elimination can serve as an example for other infectious diseases.

摘要

人类非洲锥虫病(HAT)由布氏锥虫引起,通过采采蝇昆虫媒介(舌蝇属物种)传播。它是世界卫生组织列出的20种被忽视的热带病之一。这些疾病影响着最贫困和最脆弱的社区,为此世界卫生组织制定了专门的2021 - 2030年路线图。在阿尔方斯·拉韦朗时代,HAT肆虐非洲大陆。在20世纪60年代,这种疾病几乎得到控制,但在20世纪90年代又强烈复发。所有利益相关者的协同努力,以国家控制项目为主要行动者,研究的大力贡献以及私营部门的重要捐赠,使得HAT负担显著减轻。自2018年以来,每年检测到的病例不到1000例。我们在此回顾在几个流行国家联合并成功实施的新诊断方法、治疗方法和病媒控制工具。下一个关键挑战将是维持已取得的成果。新出现的研究问题包括锥虫的长期携带以及工具对低流行情况的适应性。研究领域之外的挑战包括持续的资金需求、专业人力资源的维持以及获取这一关键问题。如果这些挑战得到解决,就可以实现作为2030年被忽视热带病路线图目标的“传播中断”式可持续消除。我们强调继续联合抗击该疾病的努力的重要性,因为可持续消除HAT是防止疾病再次出现的最佳长期预防策略。因此,消除HAT可以为其他传染病树立榜样。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7027/10387296/dbb012e03330/mtsi-03-6006-g001.jpg

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